Body-Focused Repetitive Behaviours: Dermatillomania/ Skin-Picking And Nail-Biting

Body-focused repetitive behaviour (BFRB) is the umbrella-term label given to any obsessive, compulsive, repetitive self-grooming behaviour which causes damage to an individual’s body and/or appearance. BFRBs come under the category of impulse-control behaviours, and can become so preoccupying and debilitating that they may interfere with an individual’s quality of life to a large – and rather misunderstood – degree.

The main BFRBs are dermatillomania (skin-picking) and trichotillomania (hair-pulling). Other common behaviours in the category range from nail-biting and lip-chewing, to cuticle-peeling and blemish-squeezing.

I have struggled with some of these body-focused repetitive behaviours (BFRBs) for as long as I can remember. As a child and teenager, I always had my fingernails in my mouth; my cuticles became chewed and picked to the point of bleeding and infection. As a young teenager, I became obsessed with plucking my eyebrows to the extent I barely had any left for significant periods of time. As an adult, I continue to struggle; my biggest difficulty being with picking the skin around my fingernails, and attacking the keratosis pilaris (a pretty common skin condition) on both my upper arms and legs.

Recently I have be struggling with the picking to no end, and to be honest it’s really been getting me down these last few weeks. I have constantly new or healing sores from all the picking, and a growing collection of small circular scars as a result, too. I can end up losing hours of each day as a slave to the picking, and feel trapped within a battle between my brain and body: Even though I am so desperate to STOP the behaviours, I am finding it simply impossible. Worst of all the consequences is the shame, helplessness and frustration I feel as a result, as well as the inevitable perpetuation of my low self-esteem, self-consciousness, self-hatred and self-disgust.

I have been researching on the topic a fair amount in order to try and understand exactly what I am experiencing, and why. I have been relieved to find that I relate to multiple people and sources on the Internet and in the world. To know that I am not alone in the BFRB struggles certainly reduces the shame and stigma I have felt in the past. I genuinely hadn’t realised that others have such similar struggles, obsessions and nuances as I do in this way.

Here are a few things that have struck me in my recent reading around BFRBs:

  • It is common for family members and friends to grossly misunderstand that BFRBs are not just habits that can be broken. I, like many others, have been judged and shamed by those around me who fail to comprehend the intensity of the compulsion to engage in behaviours which seem so unacceptable and off-putting to others. My mother often tells me that she feels she is “sitting next to a monkey” because I am always picking at myself. Similarly, my sister tells me that I am disgusting and shouts at me to remove myself from the room. In response to judgments such as these, my shame, anger (self-directed) and urge to hide away are reinforced.
  • People are under the false impression that we can just stop, man up, or that we simply need more willpower. This is not the case; if it were so simple, if it were a choice, we would stop in the click of a switch. BFRBs become diagnosable as a disorder when the sufferer finds that no matter how hard they try to stop, no matter how many times they have attempted to do so, they just cannot seem to get a grasp on a prolonged and liberating remission.
  • I, like many others, tend to engage in the BFRBs during one of two states of mind. The first is during periods of heightened emotion; for me specifically with anxiety and fear. During these moments, the BFRBs act as self-regulating and soothing mechanisms, and can lessen the intensity of whatever it is I am experiencing dramatically. The second state is within a more dissociative, robotic frame of mind. Oftentimes, whilst feeling on auto-pilot, the BFRBs come into play without any conscious or intentional awareness.
  • My BFRBs, like many other people’s, are an attempt to “fix” or “perfect” an irregularity or imperfection on my body, such as a loose nail or uneven patch of skin. Ironically, engaging in the behaviour – which involves attacking myself in some form – inevitably worsens the appearance of the area I am attempting to rectify. In trying to physically correct myself, I end up creating even more damage. This then leads to an increased desire to “fix” the worsening problem, which followed by the corrective action, leads to consequent further self-destruction. It is an endless and self-perpetuating cycle, and in my opinion one which is accompanied by distorted and even body-dysmorphic thinking.
  • As I have experienced, BFRBs sound pretty darn hard to treat and fully recover from. Although there are a few specific therapies targeted to help combat these difficulties, BFRB disorders remain largely stigmatised, misunderstood and dismissed within society.

I am going to start trying to combat my own skin- and nail-picking BFRBs in two ways I have discussed with my therapist. Firstly, by applying hand lotion every time I notice the urge to pick at my hands, I will attempt to replace one (more self-destructive, ineffective) behaviour with another (more loving, intentional) behaviour. Secondly, perhaps practicing Mindfulness i.e. the intentional, momentary and non-judgemental awareness of the urges will help me feel more able to make a choice about whether to engage in the behaviours, or not – instead of mindlessly picking away at myself, unaware.

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11 thoughts on “Body-Focused Repetitive Behaviours: Dermatillomania/ Skin-Picking And Nail-Biting

  1. Both my sister and I have picked at/chewed the skin around our fingernails for years. My mum used to tell us off, saying we were ‘canibals’ for doing it which only made us feel worse but still didn’t stop us!! I’ve mostly grown out of this now, but I still find myself doing it as an autopilot thing, usually when I’m a little stressed out. I find a loose bit of skin and pull it off, but then because its not even I end up trying to ‘correct’ it and make all the skin in the surrounding area the same level. This usually ends up with me ripping off too much and it bleeding everywhere.My mum says my sister still does it quite a lot. I had no idea there was a name for this, much less a disorder when it becomes something you just can’t stop. Really eye-opening and somewhat comforting that other people have similar behaviours.I feel your pain when your family tell you off for this- it’s horrible when you’ve got this compulsion (particularly to ‘correct’ stuff- jeeeeeez I can so relate to that right now!!). I hope you find a way to combat the behaviour, its tough to do xxx

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    • Wow wow wow everything you wrote is ME! Thank you so much for sharing, I can’t tell you how comforting it is to hear from others that they have experienced similar, and honestly the way you describe how it manifests for you is EXACTLY the same for me. So thank you.

      I too had (and have) that experience with my family, being told off, shamed and teased, or at best invalidated in some way or another. People just don’t understand, no matter how hard I try to explain! So it’s invaluable to hear from others like yourself. Although of course I am sorry you have these struggles because they do suck…

      Much love, take care 🙂

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      • Bloody hell!!! I thought I was the only one who did this and saw the ‘corrections’ in this way! I really believed it was just a weird family thing that me and my sister did (goodness knows why we started doing it though). We both have tendencies towards depression (she was on antidepressants for a while a few years back and I’ve been on them for last 2 years) so maybe the underlying mental health issues could be a cause? No one else we know does this, my mum doesn’t get it at all!! Although I must confess to doing it in front of her sometimes as I know it winds her up 😉 haha!! Xx

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      • Tell her to look up Body focused repetitive behaviours there is so much info out there and it may help reduce the stigma if she realises it’s a legitimate thing! Yes I definitely agree, whether it’s depression, anxiety or something else, I doubt it would manifest in the way it does for no reason. X

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  2. I only learnt of BFRBs recently, and had heard of people pulling out their hair prior to that, but hadn’t realised that my obsession with my eyebrows could come under the category of trichotillomania until I did some more reading on the subject. I have been mocked for years on my weird habit of pulling at my eyebrows, by my own family, which only does more to increase my self-hatred and anxiety. I don’t talk about it very much because I feel embarrassed that I have a compulsion to pull out my eyebrow hairs and I get totally freaked out if anyone tries to touch them. I realise now that it was worse during periods of multiple exams – I remember looking down at GCSE papers and seeing stray eyebrow hairs all over the page. I wrote a really detailed blog post about how I felt about this at one point but I lost it somewhere along the way and that was really difficult because it’s something I hardly ever talk about. I get so angry at myself for doing this, and it triggers my depression and anxiety, which although I recognise, is frustrating because it’s not in my control and if others weren’t so judgemental it wouldn’t be such a trigger 😦
    Thanks for writing this. I have no idea how I can start to keep this habit under control, because I do it subconsciously and only realise after five minutes and then I get irritated with myself, which makes me stressed and worsens the problem. I seem to always have my issues come in cycles, and it’s so hard to see a way out. It’s like the eyebrow trich is a microcosm of the rest of my mental health problems.

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    • I really relate to you and want to thank you for sharing this with me especially considering it’s about something you find very hard to talk about. I’m really sorry you are facing similar struggles and that it’s having such an impact on your life. I agree in that it does feel like a never-ending cycle of negative emotions leading to negative behaviour leading to further negative emotions and so on….
      Also it’s interesting that during times of stress e.g exams it worsens; it sort of proves the self-regulatory (though unconscious) motivation for engaging in the behaviours in coping with difficult or intense experiences.
      Whatever anyone else thinks, including yourself, I don’t judge you. Take care ❤

      Liked by 1 person

  3. :-O you psychic! I was literally picking the skin surrounding my fingernails while reading this.

    I knew as soon as you described it that this is what I had. I just thought it was a weird, bad habit. So glad I’m not alone.

    I have various little cuts near my fingernails. Little red blotches where I picked too deep and it bled. My thumb is also permanently scarred over from it. I burned it once, the skin peeled, I wanted to correct it. When the skin grew back, it peeled again, and so began a vicious cycle. It’s now discolored and my fingerprint is basically gone X-D Luckily it’s not really noticeable, so I just make up a story every once in a while when someone notices my thumb is extra red lol!

    Liked by 1 person

    • Wow I’m very happy to hear that my post helped you and that you can now put a name to your struggles – exactly how I felt when I first came across the info online 😉
      Though kg course I am sorry to hear you have similar struggles and I hope you one day are able to break free from the vicious cycle, too!

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